Successful outcomes after surgical treatment of chronic complete proximal hamstring avulsions in female athletes older than 55 years

Abstract

Introduction: Proximal hamstring avulsions are a rare pathology, usually treated conservatively in elderly patients, resulting in severe functional limitation. Surgical repair can obtain a significant improvement in functionality and quality of life. Methods: Prospective case series of 3 women over 55 years of age (mean age 61), amateur athletes, with complete proximal and retracted hamstring conjoint tendon avulsion, treated by open primary repair surgery in chronic period (>4 weeks). The study variables were functional scales (PHAT, LEFS, and SF-12) before the intervention and one year after surgery, and strength measurement with a dynamometer and digital voltage scale. Statistical analysis included the Wilcoxon t-test and the Mann–Whitney U test. Results: One year after surgery, all functional scales improved: PHAT 16 vs 83.33, LEFS 17.33 vs 68.67, P/SF-12.25.47 vs 51.14, and M/SF-12.35.42 vs 57.92. A normalization of the strength was obtained, observing a strength of 97.33% (range 72–140) and 111.67% (range 89–128) for contraction at 90° of flexion and in extension, respectively, with no differences between both legs. Digital measurement showed a strength of 99% (range 50–180). Conclusion: Surgery for complete and retracted proximal avulsions of the hamstring conjoint tendon in chronic period improves functionality and quality of life in elderly women with regular sports practice, as well as normalization of muscle strength.

Keywords

• Chronic
• Proximal hamstring avulsion
• Functional outcome
• Strength
• Surgical repair